Urban violence and African-American pregnancy outcome: an ecologic study.
OBJECTIVE
To ascertain the extent to which residence in violent communities is an independent risk factor for adverse pregnancy outcomes among impoverished (census tract median family income < $10,000/year) African-American mothers.


METHODS
A cross-sectional study was performed.


METHODS
We performed multivariate analyses on 1983 Illinois vital records, Chicago Police Department violent crime rates, and 1980 United States Census income data.


RESULTS
African-American mothers who resided in the most violent communities had a low birth weight rate of 16% compared to 12% for infants (N = 315) with mothers who lived in the least violent communities; odds ratio = 1.5 (1.0-2.1). The proportion of small-for-gestational-age infants was substantially elevated in mothers who resided in the most violent communities compared to mothers who lived in the least violent communities: 7% vs. 3%; odds ratio = 2.6 (1.5-2.1). In multivariate logistic regression models that controlled for individual risk factors, the adjusted odds ratios for low birth weight and small-for-gestational-age infants among mothers who resided in the most (compared to the least) violent communities were 1.1 (0.9-1.2) and 1.5 (1.1-2.1), respectively.


CONCLUSIONS
We conclude that a community's violent crime rate is associated with intrauterine growth retardation among infants born to African-American women.
Collins
J W
JW
Division of Neonatology-#45, Children's Memorial Hospital, Chicago, IL 60614, USA.
David
R J
RJ
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D015982:Bias; D002641:Chicago / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D015999:Multivariate Analysis; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D012042:Registries; D012307:Risk Factors; D012959:Socioeconomic Factors; D014505:Urban Population; D014754:Violence / Q000706:statistics & numerical data* / Q000639:trends